Pulmonary embolism during pregnancy: a 17-year single-center retrospective MDCT pulmonary angiography study.

Details

Ressource 1Download: Rotzinger2019_Article_PulmonaryEmbolismDuringPregnan.pdf (788.85 [Ko])
State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_3846A55AE986
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Pulmonary embolism during pregnancy: a 17-year single-center retrospective MDCT pulmonary angiography study.
Journal
European radiology
Author(s)
Rotzinger D.C., Dunet V., Ilic V., Hugli O.W., Meuli R.A., Schmidt S.
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
03/2020
Peer-reviewed
Oui
Volume
30
Number
3
Pages
1780-1789
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To determine the prevalence of pulmonary embolism (PE) and alternative diagnoses detected by computed tomography pulmonary angiography (CTPA) in pregnant women; and to assess changes over time regarding radiation dose, technical quality, and examination frequency.
This retrospective study included all pregnant women referred for CTPA due to clinically suspected PE over 17 years. Two blinded radiologists reviewed the CTPAs in consensus with regard to PE, alternative diagnoses, and technical quality. We retrieved patient data regarding radiation dose metrics and associated clinical and laboratory parameters. Subgroup comparisons were performed (Wilcoxon and Kruskal-Wallis tests).
Of the 237 identified patients, 8 (3.3%) were excluded due to inadequate technical CTPA quality, and 229 patients were analyzed (mean age, 31.7 years; mean gestational age, 28 ± 7 weeks). The four different CT systems used over the study period had similar technical quality (p = 0.28). Of 229 patients 16 (7%) patients had PE, 144 (62.9%) had no abnormal findings, and 69 (30.1%) had an alternative diagnosis (consolidation, other pulmonary opacities, pleural effusion, and basal atelectasis). Gestational age, symptoms, and D-dimer levels were not significantly different between patients with or without PE (p > 0.05). Over time, radiation dose exposure decreased by 30% (p < 0.001), while the number of annual examinations increased by > 4-folds.
In pregnant women, CTPA rarely indicates PE and more often shows alternative diagnoses. Over 17 years, the use of CTPA in pregnancy has notably increased, while the radiation dose exposure has decreased by one third.
• The use of CTPA in pregnancy has steadily risen over the last 17 years • In pregnant women, CTPA rarely reveals PE and more often shows alternative diagnoses • Recent technical improvements have substantially decreased the radiation dose exposure inherent in CTPA without reducing diagnostic image quality.
Keywords
Computed tomography angiography, Hematologic pregnancy complications, Multidetector computed tomography, Pulmonary embolism
Pubmed
Web of science
Open Access
Yes
Create date
16/11/2019 12:01
Last modification date
03/05/2020 7:02
Usage data